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All complicated cases are supposed to be referred to the Director, Compensation Services. The first step of that is to send it to a DRO in the Central Office. (Where my TDIU claim was sent). A DRO from the Central Office sent the review and recommendation to the Director who made the award. A claim for TDIU does not specifically have to be made. If you have stated that your multiple conditions that make you unable to find work, for example, TBI that makes mental work, as in desk jobs not possible, and injury residuals that make physical work not possible. While neither alone qualifies you for TDIU, in combination they do making the case complicated. My case when I was 40% combined. Awarded to the date of my last full time attempt at being employed on a desk job. I did eventually get the "presumptive ratings" after the TBI law took effect in 2009. But my award went back to 1985 when finished in 2020.

Another way is to apply for tdiu, that is, assuming you are not working. Or, if you are working, there may be other claims you overlooked.

Depending on your 90% rating breakdown, you could be 93% or 94% and the VA rounds down to a combined 90% but the additional 30% from 30% to 60% could possibly get you a 100% combined rating. All you would need is that your rating hit 95% and the VA would round up to 100% schedular.

Due to the fact that the veteran is having multiple symptoms within this category, The VA could actually rate him higher with a 60% rating. This of course does not mean they will. These are the criteria for each rating: GERD. 60 percent – the veteran experiences “pain, vomiting, material weight loss and hematemesis or melena with moderate anemia; or other symptom combinations productive of severe impairment of health.” 30 percent – the veteran experiences “persistently recurrent epigastric distress with dysphagia, pyrosis, and regurgitation, accompanied by substernal or arm and shoulder pain, productive of considerable impairment of heath.” 10 percent – the veteran has two or more symptoms of the 30 percent rating, but less severe. 4.7 Higher of two evaluations. Where there is a question as to which of two evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned.

You're maxed out. Not sure what you would gain.

Yes, you can continue to submit up until the point when it is in "Rating".

Using the online VA claim process. After one thought they submitted all support documents for a claim, and you push the button saying this is all I have, “please start my claim”, only to find out you came across something important to your claim, can you still submit it for review?

Thanks pacmanx1

Yes

Using the VA claim online process, after you submit all your evidence, it asks if you are done and want to pull the switch for it to be reviewed and decided. If for some reason, you find some other things relative to your claim, can you still submit data?

Maybe. Review the criteria for IBS/Gerd. You need to look those up yourself. As an example, many Veterans have "dual" mental health disorders..PTSD and Bipolar, and or something else. For mental health disorders, once service connected, they are rated on SYMPTOMS. Generally, VA compensates you for your percentage of your loss of an ability to earn an income. IDK what your symptoms are for IBS/Gerd and I dont know which symptoms overlap. But I do know that you dont get paid for the same symptom twice. Let me cite a hypothetical example: Lets say you have bouts of painful diarrhea which last 2 or 3 days where you can not work with Gerd "and also" with IBS. You would get compensated for one, not the other. But the Gerd may have an additional symptom. With mental heatlh disorders you get paid for all they symptoms combined into one disorder. If that makes sense. Pyramiding prevents a Veteran from getting paid for the same symptom twice. But, if I was service connected for my Right knee issue and the main symptom was pain which hurt when I walked. However, lets assume I was also SC for my back "including" back pain. Well I could get paid for symptoms of my back pain and my knee pain especially if they dont occur at the same time and I could not work 2 days a month due to back pain, and 1 day a week due to knee pain.

I’m currently rated at 30% for IBS/Gerd. I recently submitted a claim for diverticulitis which I believe would be rated under IBS. My diverticulitis symptoms are quite severe and am fairly certain it will be service connected especially considering my VA Gastro Doc provided a nexus letter. I know IBS is maxed at 30% and Gerd is 60%… So being that my IBS and Gerd are combined, would that mean that with my new Diverticultis (IBS) disability that my rating could be bumped up?

Since you are already rated 100% P & T and working, you can only get retroactive pay (money). This is if your effective date is before your current 100% P & T rating. The problem is even though the BVA granted your appeal, they remanded it to the regional office, and the regional office has to rate your percentage and assign an effective date. The regional office could assign you a 0% rating in which there would be no retroactive payment (money) and you win but you lose with no money coming your way. It could also be that with your new ratings the regional office could assign you an even earlier effective date, if your new rating boils down to you being awarded an earlier combined 100% rating. The VA did this to me and I had to file a new appeal. I was granted a 50% rating after my 100% P & T rating which amounted to absolutely no money in retroactive pay. When I filed my appeal, the BVA granted me an unadjudicated award going back to my original date of claim and I won my earlier effective dates.

Please excuse if this is a duplicate. Follow up Status: Entitled to Backpay if Legacy Claim is Adjudicated and Veterans is Already 100% SC I'm open to any insight and or shared experience. Thank you. Judge remanded conditions. Ordered VA to do another C&P exam, stated the previous exam was inadequate. Conditions were lost in VA "black hole" for over 20 years, finally adjudicated after PACT. I have an exam on Monday, I will definitely attend, however, not sure what to expect. Just wondering if this process will affect my current rating - 100% P & T. I am a DS Vet, served in Southwest Asia during Persian Gulf War. The board noted in my summary "the Veteran is a Persian Gulf War Veteran and presumptive toxic exposure under 38 U.S.C. 1117 has been conceded." I read somewhere that "veterans with Chronic Fatigue Syndrome, especially those who were diagnosed long after leaving the military, are eligible under the law for Chronic Fatigue Syndrome Secondary to PTSD. Two Remanded conditions - Chronic Fatigue Syndrome (no formal diagnosis) as due to immunizations and as secondary to service-connected PTSD. (I am already 70% sc PTSD). Entitlement to service connection for fibromyalgia (no formal diagnosis), including multiple joint pains. Current Adjudicated Rating SC Sleep Apnea secondary to PTSD - 50 PTSD - 70 Chronic Sinusitis - 10 Cancer Residuals - 30 Neuropathy secondary to cancer treatments bilateral hands 30 right/30 left bilateral feet 20 right/20 left Painful surgical breast scar - 10 Tinntis - 10 Chronic Rhinitis - 0

A lot of times they request another C&P exam because the prior one may have missed something or they want a second opinion. It happened to me a lot and came out in my favor. Just go to the C&P exam and wait for the results. QTC has been fair with me on every C&P exam except one. If it comes back unfavorable, then get back to us. You can contest the exam with the VARO. I've done this with success and can guide you.

Not sure how this will work, but you might get a 4th year (3 years under the 9/11 bill) of benefits if you were originally eligible for the Montgomery GI Bill. https://www.militarytimes.com/education-transition/2024/04/16/supreme-court-rules-in-favor-of-veteran-who-sued-over-gi-bill-limits/

Thanks Pac. I think you are correct and I believe former member did, thinking back on it. I'm checking for my Ex. She went on his P&T Chap 35 and now that she's receiving DIC due to his death, the award shows a new Chap 35 award. Thx again!

The only thing I can say is when I was going through Voc Rehab. The lady there told me to apply for PELL GRANT and any loans I felt that I needed. This was before I was rated 100% P & T. She told me that when/if funds are available or came available after all loans were paid out. They look for potential students that they could help and grant their loans. As to CH 35 I think I read here that a former member used CH 35 twice, once while her husband was alive and later after she was granted DIC and CH 35.

Thanks, bronco & Pac. Although it still leaves me wondering. I know if you use college benefits, previously, they claim that there are limited funds available for you, for voc rehab. I was just wondering since it's a new claim. The other thing is if a spouses Chap ed 35 bennies from a previous marriage would be awarded more from a new spouse? I think they would but who knows w/the VA.

Bump

I had my prostate removed in 2019 but I guess not soon enough. I have been getting PSA tests every six months since. Each test shows the antigens slowing increasing. A community doctor has been treating me since 2019. In 2021 I started urinating frank blood. It was determined I had a bladder tumor that had broken off of the bladder wall. Same doctor now treating me for both prostate and bladder cancer. I have had a cystoscopy done every 3-4 months since. I am now scheduled for my 7th bladder surgery in the last 3 years. The same day I was told about the most recent bladder tumor. I returned home to be told I will be scheduled for another C&P. This I think is my 5th C&P, the last was last year in June. It seems for every C&P, I was either just recovering or awaiting another bladder surgery. I understand that VA-B does not like to award 100% P&T for prostate/bladder cancer. But with my history of the bladder tumors returning numerous times. This is even after a 6 weeks of BCG treatments. My question is there a chance the 5th time may determine the P&T status? Or do I just continue with cystoscopy every 3 months and a couple of surgeries a year and yearly C&P's? Thanks for any advise. Paul

Short answer: C and P exams are at VA's discrection and we dont know. However, its not that unusual the C and P exam is insufficient for rating. Many things can be omitted or inaccurate. Some examples: 1. "If" already service connected, then symptoms need to be documented. 2. A date needs to be given when symptoms began. The VARO often uses the date of the c and p exam, but that may not fly with the BVA or above. It does not take a rocket scientist to figure out if you have been treated for a disorder since 2002, and they gave you a c and p exam in April, 2024, your symptoms did not begin in April 2024. They began Much earlier. How much earlier? That needs to be documented by a doctor for a real accurate effective date. 3.. Etiology. "If" the examiner opined that your condition was at least as likely as not due to an event in service, they often want a medical rational as to why the examiner said same. 4. There can be other things, too, such as it would be impossible to tell from the exam, which if any of the applicable criteria were met. 5. Finally, the exam may be incomplete, may not be signed or dated. Or, the exam may be ambigious, or may be in conflict with other exams.

According to the VA website, you can get one or the other, but you can not switch: https://www.va.gov/education/survivor-dependent-benefits/#:~:text=If you're a dependent,%2C you can't switch. This said, you can not always trust what the VA employees, or even VA websites tell you. Yes, I know its disappointing. IRS is the same way. You could call the IRS hotline for tax advice, then take their advice. If the advice is wrong, you could still have to pay the applicable tax penalties or interest. Neither the VA, nor the IRS permits a GS5, or whover, works on updating the website, to make "official" statements binding on the agency. In law enforcement, its actually worse. More than once, a sheriff or detective lies to the accused, for example, they may tell them that. "your brother already ratted you out", when that is not true. Tricks (aka lies) often lead to arrests and or convictions. While Im no expert on law, Im pretty sure that, even if you are convicted based on a lie the sheriff told you, you are still convicted. The sheriff is not on trial..the accused is. I can see how, in some peoples mind, at least, its okay to fight fire with fire, as many/most criminals will lie to prevent conviction. Sadly, sometimes, it may even work, at least for a while.

I know this is not what you want to hear but Memos are for internal use and more for VA personnel than to the veteran.